Limited-access, reduced-pressure systems and methods

ABSTRACT

A reduced-pressure treatment system for applying reduced pressure to a tissue site at a limited-access location on a patient includes a reduced-pressure source, a treatment manifold for placing proximate the tissue site and operable to distribute reduced pressure to the tissue site, and a sealing member for placing over the tissue site and operable to form a pneumatic seal over the tissue site. The reduced-pressure treatment system also includes a reduced-pressure bridge and a moisture-removing device on at least portion of the reduced-pressure bridge. The reduced-pressure bridge includes a delivery manifold operable to transfer the reduced pressure to the treatment manifold, an encapsulating envelope at least partially enclosing the delivery manifold and having a patient-facing side, and a reduced-pressure-interface site formed proximate one end of the reduced-pressure bridge.

RELATED APPLICATIONS

The present invention claims the benefit, under 35 USC §119(e), of thefiling of U.S. Provisional Patent Application Ser. No. 61/103,566, filedOct. 8, 2008, entitled, “System and Method for Applying Reduced Pressureto a Patient's Limb, Such As a Foot,” which is incorporated herein byreference for all purposes.

BACKGROUND

The present invention relates generally to medical treatment systemsand, more particularly, to limited-access, reduced-pressure systems andmethods.

Clinical studies and practices have shown that providing reducedpressure in proximity to a tissue site augments and accelerates thegrowth of new tissue at the tissue site. The applications of thisphenomenon are numerous, but application of reduced pressure has beenparticularly successful in treating wounds. This treatment (frequentlyreferred to in the medical community as “negative pressure woundtherapy,” “reduced pressure therapy,” or “vacuum therapy”) provides anumber of benefits, which may include faster healing and increasedformulation of granulation tissue. Unless otherwise indicated, as usedherein, “or” does not require mutual exclusivity.

Providing reduced pressure to limited-access locations has beendifficult. One example of a difficult limited-access location is thebottom sole (plantar) of a patient's foot or other anatomical locationsthat are difficult to service. A related illustrative example of alimited-access location is inside an offloading device, such as awalking boot or removable walker. Another example of a limited-accesslocation is a tissue site on a bed-ridden patient's back. Otherillustrative examples include a tissue site under a compression garmentand sacral wounds on the foot.

SUMMARY

Problems with existing reduced-pressure treatment devices and systemsare addressed by the systems, apparatus, and methods of the illustrativeembodiments described herein. According to an illustrative embodiment, areduced-pressure treatment system for applying reduced pressure to atissue site at a limited-access location on a patient includes areduced-pressure source, a treatment manifold for placing proximate thetissue site and operable to distribute reduced pressure to the tissuesite, and a sealing member for placing over the tissue site and operableto form a pneumatic seal over the tissue site. The reduced-pressuretreatment system also includes a reduced-pressure bridge that includes adelivery manifold operable to transfer the reduced pressure to thetreatment manifold, an encapsulating envelope at least partiallyenclosing the delivery manifold and having a patient-facing side, areduced-pressure-interface site formed proximate one end of thereduced-pressure bridge. The reduced-pressure treatment system alsoincludes a moisture-removing device.

According to another illustrative embodiment, a reduced-pressure bridgefor delivering reduced pressure to a reduced-pressure dressing from aremote site includes a delivery manifold operable to transfer a reducedpressure and an encapsulating envelope at least partially enclosing thedelivery manifold and having a patient-facing side. Areduced-pressure-interface site is formed proximate a second end of thereduced-pressure bridge. The encapsulating envelope has a secondaperture formed on the patient-facing side of the encapsulatingenvelope. The reduced-pressure bridge also includes a moisture-removingdevice on at least a portion of the encapsulating envelope.

According to another illustrative embodiment, a method for deliveringreduced pressure to a tissue site at a limited-access location includesthe steps of: disposing a first manifold proximate the wound anddisposing a sealing member over the first manifold. The sealing memberhas a first aperture. The method for delivering reduced pressure to atissue site further includes providing a reduced-pressure bridge havinga first end and a second end. The reduced-pressure bridge has a secondaperture proximate the first end, a moisture-removing device, and asecond manifold. The method for delivering reduced pressure to a tissuesite further includes coupling a reduced-pressure interface to thesecond end of the reduced-pressure bridge; disposing the first end ofthe reduced-pressure bridge over at least a portion of the sealingmember with the second aperture substantially aligned with the firstaperture. The first manifold may be at least partially encapsulated withan encapsulating envelope that has a patient-facing side. The method fordelivering reduced pressure to a tissue site may further include fluidlycoupling a reduced-pressure source to the reduced-pressure interface.

According to another illustrative embodiment, a reduced-pressuretreatment kit includes a reduced-pressure bridge, the reduced-pressurebridge, a reduced-pressure interface, a reduced-pressure deliveryconduit, a manifold unit, and a perforated sealing sheet. The manifoldunit has a plurality of preformed treatment manifolds. The perforatedsealing sheet is operable to be torn into a plurality of securing stripsand a sealing member.

Other objects, features, and advantages of the illustrative embodimentswill become apparent with reference to the drawings and detaileddescription that follow.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic, perspective view with a portion shown as a blockdiagram of an illustrative reduced-pressure treatment system utilizing areduced-pressure bridge;

FIG. 2A is schematic, plan view of an illustrative reduced-pressurebridge;

FIG. 2B is a schematic, perspective, exploded view of the illustrativereduced-pressure bridge of FIG. 2A;

FIG. 2C is a schematic, cross-sectional view taken along line 2C-2C ofthe illustrative reduced-pressure bridge of FIG. 2A;

FIG. 2D is a schematic, cross-sectional view of an alternativeillustrative reduced-pressure bridge;

FIG. 3 is schematic, perspective view showing an illustrativereduced-pressure bridge being coupled with a reduced-pressure interface;

FIG. 4 is a schematic, plan view of the reduced-pressure bridge of FIG.3 with the reduced-pressure interface installed;

FIG. 5 is a schematic diagram of an illustrative reduced-pressuretreatment system utilizing a reduced-pressure bridge shown on a traversesection through an abdomen of a patient on a bed;

FIG. 6 is a schematic diagram of an illustrative embodiment of areduced-pressure treatment kit for use with limited-access tissue sites;

FIG. 7A is a schematic, perspective view of an illustrative manifoldunit; and

FIG. 7B is a schematic plan view of the manifold unit of FIG. 7A.

DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS

In the following detailed description of the illustrative embodiments,reference is made to the accompanying drawings that form a part hereof.These embodiments are described in sufficient detail to enable thoseskilled in the art to practice the invention, and it is understood thatother embodiments may be utilized and that logical structural,mechanical, electrical, and chemical changes may be made withoutdeparting from the spirit or scope of the invention. To avoid detail notnecessary to enable those skilled in the art to practice the embodimentsdescribed herein, the description may omit certain information known tothose skilled in the art. The following detailed description is,therefore, not to be taken in a limiting sense, and the scope of theillustrative embodiments are defined only by the appended claims.

Referring to FIG. 1, an illustrative embodiment of a reduced-pressuretreatment system 100 is presented. The reduced-pressure treatment system100 has an illustrative embodiment of a reduced-pressure bridge 102. Thereduced-pressure bridge 102 facilitates reduced-pressure treatment of atissue site 104 and in particular a limited-access tissue site, which inthis illustration is on the bottom sole (plantar) of a patient's foot106 and also within an offloading device, e.g., offloading boot 108(shown in hidden lines). The reduced-pressure treatment system 100 maybe used with a tissue site at a non-limited-access site or alimited-access site. Other illustrative examples of limited-accesstissue sites include on a patient's back, under a compression garment,in a total contact casting (TCC), in a removable walker, in a healingsandal, in a half shoe, in an ankle foot orthoses, etc. Thereduced-pressure treatment system 100 may be used with the bodily tissueof any human, animal, or other organism, including bone tissue, adiposetissue, muscle tissue, dermal tissue, vascular tissue, connectivetissue, cartilage, tendons, ligaments, or any other tissue.

The reduced-pressure bridge 102 provides a low profile source of reducedpressure to be supplied to the limited-access tissue site 104 andthereby may increase patient comfort and enhance reliability of thereduced-pressure supply to the limited-access tissue site 104. Becauseof the low profile of the reduced-pressure bridge 102, thereduced-pressure bridge 102 may readily be used with an offloadingdevice. As such, the reduced-pressure bridge 102 may allow the patientthe benefit of both reduced-pressure treatment as well as the offloadingof physical pressure. As described further below, the reduced-pressurebridge 102 may include a moisture-removing device, e.g.,moisture-removing device 216 in FIG. 2B, that helps to avoid macerationof a patient's skin by removing moisture from the patient's skin.

The reduced-pressure bridge 102 has a first end 110 that is placedproximate the limited-access tissue site 104 and a second end 112. Thesecond end 112 has a reduced-pressure-interface site 114 that is forreceiving a reduced-pressure interface 116, which may be a port, such asa TRAC Pad® interface or a SensaT.R.A.™ pad interface from KineticConcepts, Inc. of San Antonio, Tex. The second end 112 is typicallyplaced at a location on or near the patient that provides convenientaccess by the healthcare provider, such as a convenient location forapplying reduced-pressure to the reduced-pressure-interface site 114.When an offloading device, e.g., offloading boot 108, is utilized, thereduced-pressure bridge 102 would extend from the tissue site to a placeoutside of the offloading device. The actual length (L) of thereduced-pressure bridge 102 may be varied to support use with aparticular offloading device or application.

A reduced-pressure delivery conduit 118 may fluidly couple thereduced-pressure interface 116 to a reduced-pressure source 120. Thereduced-pressure source 120 may be any device or means for supplying areduced pressure, such as a vacuum pump or wall suction. While theamount and nature of reduced pressure applied to a site will varyaccording to the application, the reduced pressure will typically bebetween −5 mm Hg and −500 mm Hg or more typically between −25 mm Hg to−200 mm Hg. For vertical applications of the reduced-pressure bridge102, such as is shown in FIG. 1 on an ambulatory patient's leg, aspecified minimum reduced pressure may be necessary to ensure properfluid flow. For example in one embodiment, a reduced pressure of atleast −125 mm Hg has been suggested as a minimum, but other pressuresmay be suitable for different situations. As used herein, “reducedpressure” generally refers to a pressure less than the ambient pressureat a tissue site that is being subjected to treatment. In most cases,this reduced pressure will be less than the atmospheric pressure atwhich the patient is located. Alternatively, the reduced pressure may beless than a hydrostatic pressure at the tissue site. Unless otherwiseindicated, values of pressure stated herein are gauge pressures.Although the terms “vacuum” and “negative pressure” may be used todescribe the pressure applied to the tissue site, the actual pressureapplied to the tissue site may be more than the pressure normallyassociated with a complete vacuum. Consistent with the use herein, anincrease in reduced pressure or vacuum pressure typically refers to arelative reduction in absolute pressure. In one illustrative embodiment,a V.A.C.® Therapy Unit by Kinetic Concepts, Inc. of San Antonio may beused as the reduced-pressure source 120.

Depending on the application, a plurality of devices may be fluidlycoupled to the reduced-pressure delivery conduit 118. For example, afluid canister 122 or a representative device 124 may be included. Therepresentative device 124 may be another fluid reservoir or canister tohold exudates and other fluids removed. Other examples of device 124that may be included on the reduced-pressure delivery conduit 118include the following non-limiting examples: a pressure-feedback device,a volume detection system, a blood detection system, an infectiondetection system, a flow monitoring system, a temperature monitoringsystem, a filter, etc. Some of these devices may be formed integral tothe reduced-pressure source 120. For example, a reduced-pressure port126 on the reduced-pressure source 120 may include a filter member thatincludes one or more filters, e.g., an odor filter.

Referring now to FIGS. 2A-2C, an illustrative, reduced-pressure bridge200 will be presented. The illustrative, reduced-pressure bridge 200 hasa first end 202 and a second end 204. The first end 202 of theillustrative, reduced-pressure bridge 200 is configured to providereduced pressure to a first manifold, or treatment manifold (e.g.,treatment manifold 310 in FIG. 5) and the second end 204 has areduced-pressure-interface site 206.

Referring primarily to FIG. 2B, the layers that make up theillustrative, reduced-pressure bridge 200 are presented. A firstencapsulating member 210 is on a first side 208 of the illustrative,reduced-pressure bridge 200. The first encapsulating member 210 may havean aperture 211 formed proximate the second end 204. A second manifold,or delivery manifold 212, is disposed proximate the first encapsulatingmember 210. A second encapsulating member 214 is disposed proximate asecond side of the delivery manifold 212. The second encapsulatingmember 214 may be formed with an aperture 213 proximate the first end202. A moisture-removing device 216 is disposed proximate the secondencapsulating member 214, which in this illustrative embodiment is awicking layer 218. A releasable backing member or release liner 220 maybe included on the first end 202 to releasably cover an adhesive as isexplained further below. The releasable backing member 220 may be formedwith an aperture 222 that aligns with the aperture 213 in the secondencapsulating member 214.

The delivery manifold 212 may be any material capable of transferringreduced pressure. In one embodiment, the delivery manifold 212 is a foammaterial, such as a GranuFoam® material from Kinetic Concepts, Inc. ofSan Antonio, Tex. The delivery manifold 212 may be formed from the samematerial as a treatment manifold (e.g., treatment manifold 310 in FIG.5). The delivery manifold 212 may have any thickness, such as athickness in the range of 3-20 millimeters, 5-10 millimeters, 6-7millimeters, etc. The thickness of the delivery manifold 212 may bevaried to minimize or eliminate pressure points on the tissue site. Thethickness of the delivery manifold 212 may also be selected to supportfluid removal from the tissue site and transfer into a canister (e.g.,fluid canister 122 in FIG. 1).

The first encapsulating member 210 and the second encapsulating member214 may be composed of any material that facilitates maintaining reducedpressure within a first encapsulating envelope 229 formed from the firstencapsulating member 210 and the second encapsulating member 214. In oneembodiment, the first encapsulating member 210 and the secondencapsulating member 214 include a polyurethane film, but any suitabledrape material may be readily used, such as any natural rubbers,polyisoprene, styrene butadiene rubber, chloroprene rubber,polybutadiene, nitrile rubber, butyl rubber, ethylene propylene rubber,ethylene propylene diene monomer, chlorosulfonated polyethylene,polysulfide rubber, polyurethane, EVA film, co-polyester, silicones, 3MTegaderm® drape material, or acrylic drape material, such as oneavailable from Avery. These are non-limiting examples.

Referring now primarily to FIGS. 2A and 2C, a periphery portion 224 ofthe first encapsulating member 210 and a periphery portion 226 of thesecond encapsulating member 214 may be coupled, such as by RF weld 228,to form the first encapsulating envelope 229. As used herein, the term“coupled” includes coupling via a separate object and includes directcoupling. The term “coupled” also encompasses two or more componentsthat are continuous with one another by virtue of each of the componentsbeing formed from the same piece of material. Also, the term “coupled”may include chemical, mechanical, or thermal coupling. Fluid couplingmeans that fluid is in communication between the designated parts orlocations. The first encapsulating member 210 and the secondencapsulating member 214 may be coupled using any technique, includingwithout limitation welding (e.g., ultrasonic or RF welding), bonding,adhesives, cements, etc. The first encapsulating envelope 229 maycompletely enclose the delivery manifold 212. The moisture-removingdevice 216 may be coupled to at least a portion of the firstencapsulating envelope 229 using any technique. The wicking layer may becoupled to a patient-facing side 230 of the second encapsulating member214 of the first encapsulating envelope 229.

The moisture-removing device 216 pulls moisture, e.g., perspiration,away from a patient's skin and thereby helps to avoid maceration of thepatient's skin and enhances comfort. The extent of the wicking layer 218can be varied both laterally (width) and longitudinally (lengthwise).For example, the wicking layer 218 may cover 100 percent or more than 90percent, 80 percent, 70 percent, 60 percent, or 50 percent of thepatient-facing second encapsulating member 24. The wicking layer 218pulls moisture to a place where the moisture can evaporate more readily.In the illustrative embodiment of FIGS. 2A-2C, the moisture-removingdevice 216 is the wicking layer 218. For example, the wicking layer 218may be a cloth-material drape, a non-woven fabric, a knitted polyesterwoven textile material, such as the one sold under the name InterDry® AGmaterial from Coloplast A/S of Denmark, GORTEX® material, DuPontSoftesse® material, etc.

Referring now to FIG. 2D, an alternative embodiment of themoisture-removing device 216 is presented. In this embodiment, a thirdencapsulating member 232 is provided with a plurality of apertures orfenestrations 234. The third encapsulating member 232 covers all or atleast a portion of a third manifold 236, or comfort manifold. Aperiphery portion of the third encapsulating member 232 is also coupledby any technique, such as by RF weld 228. In conjunction with the secondencapsulation member 214, the third encapsulation member 232 forms asecond encapsulating envelope 238. In operation, a reduced pressure issupplied within the second encapsulation member 214 and any fluidagainst a patient's skin is pulled through the plurality of apertures234 into the third manifold 236 and delivered elsewhere, e.g., to acanister, for storage or disposal.

In still another alternative embodiment of the moisture-removal device216, a moisture vapor permeable material is pneumatically coupled to anegative pressure source to provide active removal adjacent theillustrative, reduced-pressure bridge 200. In still another illustrativeembodiment, apertures may be formed on the second encapsulating member214 that allow the reduced pressure in the first encapsulating envelope229 to pull fluids into the delivery manifold 212. In still anotherillustrative embodiment of a moisture-removing device, apertures may beformed in the second encapsulating member 214 that allow the reducedpressure in the first encapsulating envelope 229 to pull fluids into thedelivery manifold 212, and reduced-pressure valves may be associatedwith the apertures that close when reduced pressure is absent.

Referring again primarily to FIGS. 2A-2C, the illustrative,reduced-pressure bridge 200 has a length (L), a width (W), and athickness (T). The illustrative, reduced-pressure bridge 200 preferablyhas a low of profile, e.g., small dimension T, as possible. Fornon-limiting examples, T may be 30 mm, 20 mm, 15 mm, 10 mm, 5 mm, orless. In other embodiments, T may take any size. Moreover, the comfortor function of the illustrative, reduced-pressure bridge 200 may beenhanced by using a length (L) to width (W) ratio that involves havingthe length dimension greater than the width. For example, in oneembodiment, the relationship is L>2W. In another illustrativeembodiment, the relationship is L>6W. In another illustrativeembodiment, the relationship is L>12W. In another illustrativeembodiment, the relationship is L>15W. In one illustrative embodiment, Lis approximately 668 mm and W is approximately 56 mm.

Referring now to FIG. 3, the illustrative reduced-pressure bridge 200 isshown with a reduced-pressure interface 240 about to be coupled to thereduced-pressure-interface site 206 of the illustrative,reduced-pressure bridge 200. The aperture 211 in the first encapsulatingmember 210 substantially aligns with a central portion of thereduced-pressure interface 240 to provide a fluid coupling. Areduced-pressure delivery conduit 242 is coupled at one end to thereduced-pressure interface 240 and at the other end has a fitting 244that facilitates coupling to a reduced-pressure source (not shown). Arestricting clip or clamp 246 and a visual indicia flag 248 may also beincluded on a portion of the reduced-pressure delivery conduit 242. FIG.4 shows a plan view with the reduced-pressure interface 240 coupled tothe reduced-pressure-interface site 206.

Referring now to FIG. 5, a reduced-pressure treatment system 300 ispresented. The reduced-pressure treatment system 300 is shown deployedto treat a tissue site 302 on a patient's back 304. If the patient isbed-ridden, the patient's back 304 may be pressed against a portion of abed 306. In such a situation, the use of a reduced-pressure bridge 308,or transfer member, as part of the reduced-pressure treatment system 300may be particularly beneficial to the patient. The reduced-pressurebridge 308 is analogous to the illustrative, reduced-pressure bridge 200presented above.

A treatment manifold 310 is disposed proximate the tissue site 302. Asealing member 312 having an attachment device 314 on a patient-facingside is disposed over the treatment manifold 310. The term “manifold” asused herein generally refers to a substance or structure that helps todistribute reduced-pressure and to transport fluids. The treatmentmanifold 310 typically includes a plurality of flow channels or pathwaysthat are interconnected to improve distribution of fluids provided toand removed from the tissue site 302 around the treatment manifold 310.The treatment manifold 310 may be a biocompatible material that iscapable of being placed in contact with the tissue site 302 anddistributing reduced pressure to the tissue site 302. Examples oftreatment manifolds 310 may include, for example, without limitation,devices that have structural elements arranged to form flow channels,such as, for example, cellular foam, open-cell foam, porous tissuecollections, liquids, gels, and foams that include, or cure to include,flow channels. The treatment manifold 310 may be porous and may be madefrom foam, gauze, felted mat, or any other material suited to aparticular biological application. In one embodiment, the treatmentmanifold 310 is a porous foam and includes a plurality of interconnectedcells or pores that act as flow channels. The porous foam may be apolyurethane, open-cell, reticulated foam, such as a GranuFoam® materialmanufactured by Kinetic Concepts, Incorporated of San Antonio, Tex. Insome situations, the treatment manifold 310 may also be used todistribute fluids, such as medications, antibacterials, growth factors,and various solutions to the tissue site 302.

The attachment device 314 may be used to hold the sealing member 312against the patient's epidermis or another layer, such as a gasket oradditional sealing member. The attachment device 314 may take numerousforms, e.g., a medically acceptable, pressure-sensitive adhesive,cement, hydrocolloid, etc.

The sealing member 312 and the attachment device 314 are formed with afirst aperture 318. The sealing member 312 may be any material thatprovides a pneumatic seal. The sealing member may, for example, be animpermeable or semi-permeable, elastomeric material that has pore sizesless than about 20 microns. “Elastomeric” means having the properties ofan elastomer. Elastomeric material, or elastomers, generally refers to apolymeric material that has rubber-like properties. More specifically,most elastomers have elongation rates greater than 100% and asignificant amount of resilience. The resilience of a material refers tothe material's ability to recover from an elastic deformation. Examplesof elastomers may include, but are not limited to, natural rubbers,polyisoprene, styrene butadiene rubber, chloroprene rubber,polybutadiene, nitrile rubber, butyl rubber, ethylene propylene rubber,ethylene propylene diene monomer, chlorosulfonated polyethylene,polysulfide rubber, polyurethane, EVA film, co-polyester, and silicones.Specific examples of sealing member materials include a silicone drape,3M Tegaderm® drape, acrylic drape such as one available from AveryDennison, or an incise drape.

The reduced-pressure bridge 308 has a first end 320 and a second end322. A first encapsulating member 324 is coupled to a secondencapsulating member 326 to form an encapsulating envelope 328. Thefirst encapsulating envelope 328 encloses, at least in part, a deliverymanifold 330. The second encapsulating member 326 has a second aperture332 proximate the first end 320. The second aperture 332 is sized andconfigured to align with the first aperture 318. A reduced-pressureinterface 334 is fluidly coupled at a reduced-pressure-interface site336. The reduced-pressure interface 334 is fluidly coupled to a thirdaperture 338. A reduced-pressure delivery conduit 340 fluidly couples areduced-pressure source (not shown) to the reduced-pressure interface334. A moisture-removing device 342 is coupled to the patient-facingside of the encapsulating envelope 328 and in particular to the secondencapsulating member 326.

Referring now to FIG. 6, a schematic diagram of an illustrativeembodiment of a reduced-pressure treatment kit 400 for use withlimited-access tissue sites is presented. The reduced-pressure treatmentkit 400 facilitates organized and efficient application of reducedpressure to a tissue site and particularly to a limited-access tissuesite. The reduced-pressure treatment kit 400 may include a sealedpackage or container that is opened by a healthcare provider. Thereduced-pressure treatment kit 400 may include a reduced-pressure bridge402, a reduced-pressure interface 404, a reduced-pressure deliveryconduit 408, a ruler 416, a manifold unit 418, and a perforated sealingsheet 420, or any combination thereof. The ruler 416 may be used to helpsize the dimensions of the wound and may provide other information tohelp assess a wound.

The reduced-pressure bridge 402 may be analogous the reduced-pressurebridges 102, 200, and 308 previously presented. The reduced-pressurebridge 402 has a first end 403 and a second end 405. A reduced-pressureinterface 404 may be coupled to a reduced-pressure-interface site 406 onthe reduced-pressure bridge 402. The reduced-pressure delivery conduit408 may be coupled to the reduced-pressure interface 404. Thereduced-pressure delivery conduit 408 may include a visual indicia flagor label 410 and restricting clip or clamp 412. A fitting 414 may becoupled at one end of the reduced-pressure delivery conduit 408 tofacilitate coupling to a reduced-pressure source (not shown). That thereduced-pressure bridge 402 is already encapsulated as provided in thereduced-pressure treatment kit 400 allows for easy application andrequires minimal work to deploy the reduced-pressure bridge 402.

The perforated sealing sheet 420 has adhesive on a patient-facing sideand has a releasable backing or release liner that covers the adhesiveuntil it is ready for application. A plurality of perforations, e.g.,mid-line perforation 422, provides a location where the healthcareprovider may readily tear the perforated sealing sheet 420 to form newmembers. Thus, for example, a portion of the mid-line perforation 422, afirst longitudinal perforation 424, and a portion of an end perforation426 may be torn to form a first sealing member 428, which has anaperture 430. The sealing member 428 may be used to secure a treatmentmanifold in place. Other longitudinal perforations 432 may be torn toform securing strips 434 that are used to hold the reduced-pressurebridge 402 in place as will be described further below.

The illustrative manifold unit 418, which is also shown in FIGS. 7A and7B, is made of a manifold material. For example, the manifold unit 418may be formed from a reticulated foam, such as a Granufoam® materialfrom Kinetic Concepts, Inc. of San Antonio, Tex. The manifold unit 418has a number of pre-cut manifold components that may be used. Forexample, a first treatment manifold 436 is formed and has a connectionstem 438 that be readily torn. Numerous additional treatment manifolds,e.g., second treatment manifold 440 and third treatment manifold 442,may be included. A mid-portion of the manifold unit 418 may have aprecut 444, which is cut all the way through except for a small tag orportion 446 used to hold the manifold unit 418 together until torn. Whenthe stems, e.g., stem 438, are torn and the tag 446 is torn, twomanifold blocks 448 and 450 are formed.

Referring now primarily to FIGS. 5 and 6, an illustrative deployment ofa reduced-pressure treatment system, such as the reduced-pressuretreatment system 300, will be described. The wound or tissue site (e.g.,tissue site 302 in FIG. 5) may first be prepared, such by removal of anyother dressings and debriding the wound and the peri-wound area. Thewound or tissue may be assessed with respect to size and condition.

The perforations, e.g., midline perforation 422, on the perforatedsealing sheet 420 are tom. Tearing the perforations produces the sealingmember 428, which has aperture 430, a plurality of securing strips 434,and an additional sealing member 429.

A treatment manifold (e.g., treatment manifold 310 in FIG. 5) is placedproximate the tissue site, e.g., a wound. Depending on the size, thehealthcare provider may tear off the first treatment manifold 436,second treatment manifold, 440, or third treatment manifold 442 from themanifold unit 418 in the reduced-pressure treatment kit 400. If the sizeis notably different, a custom treatment manifold may be cut from one ofthe manifold blocks 448, 450. The properly sized treatment manifold isplaced proximate the tissue site. If more than one treatment manifold isused, the number may be recorded on the visual indicia flag 410. Then,the sealing member 428 is attached over the wound or tissue site 302with the aperture 430 centered thereon. The sealing member 428 may firstneed to be trimmed to an appropriate size, which in one embodimentprovides a 3-5 mm border around the tissue site. To attach the sealingmember 428, the release liner may be removed and the adhesive placedagainst a portion of intact epidermis; this is analogous to theattachment device 314 being used to attach the sealing member 312 to theepidermis in FIG. 5. The reduced-pressure bridge, e.g., reduced-pressurebridge 402, is then installed.

A release liner (e.g., release liner 220 in FIG. 2B) is removed exposingan adhesive on the first end 403 of the reduced-pressure bridge 402, andan aperture (e.g., aperture 213 in FIG. 2B) on the reduced-pressurebridge 402 is substantially aligned with the aperture 430 on the sealingmember 428 (e.g., sealing member 312 in FIG. 5) and then the first end403 pressed against the sealing member 428. The second end 405 of thereduced-pressure bridge 402 is placed at a convenient location and thesecuring strips 434 are used to secure the reduced-pressure bridge 402in the desired location and at a point in between as desired. If thereduced-pressure bridge 402 is longer than desired, a fold shaped like a“Z” may be added into the reduced-pressure bridge 402 to shorten theeffective length.

A reduced-pressure source (e.g., reduced-pressure source 120 in FIG. 1)may then be provided and the fitting 414 on the reduced-pressuredelivery conduit 408 coupled to the reduced-pressure source or toanother conduit supplying reduced pressure. The reduced-pressure sourcemay then be activated.

Although the present invention and its advantages have been disclosed inthe context of certain illustrative, non-limiting embodiments, it shouldbe understood that various changes, substitutions, permutations, andalterations can be made without departing from the scope of theinvention as defined by the appended claims.

1. A reduced-pressure treatment system for applying reduced pressure toa tissue site at limited-access location on a patient, thereduced-pressure treatment system comprising: a reduced-pressure sourceoperable to supply reduced pressure; a treatment manifold for placingproximate the tissue site and operable to distribute reduced pressure tothe tissue site; a sealing member for placing over the tissue site andoperable to form a pneumatic seal over the tissue site, the sealingmember having a first aperture; and a reduced-pressure bridge having afirst end and a second end, the reduced-pressure bridge comprising: adelivery manifold operable to transfer the reduced pressure to thetreatment manifold, a first encapsulating envelope at least partiallyenclosing the delivery manifold and having a patient-facing side, areduced-pressure-interface site formed proximate the second end of thereduced-pressure bridge, a second aperture formed on the patient-facingside of the first encapsulating envelope, wherein the reduced pressureis transferred to the tissue site via the second aperture, and amoisture-removing device on at least a portion of the firstencapsulating envelope.
 2. The system of claim 1 wherein the firstencapsulating envelope comprises: a first encapsulating member having afirst perimeter portion; a second encapsulating member having a secondperimeter portion; and wherein the first perimeter portion is coupled tothe second perimeter portion such that the delivery manifold is at leastpartially enclosed by the first encapsulating member and the secondencapsulating member.
 3. The system of claim 2 further comprising areduced-pressure interface coupled to the reduced-pressure interfacesite and wherein the reduced-pressure source is fluidly coupled to thereduced-pressure interface.
 4. The system of claim 1 wherein themoisture-removing device comprises a wicking material on thepatient-facing side of the first encapsulating envelope, the wickingmaterial adapted to contact a remote tissue portion and to absorb liquidfrom the remote tissue portion.
 5. The system of claim 4 wherein thewicking material extends along a length of the first encapsulatingenvelope.
 6. The system of claim 1 wherein the moisture-removing devicecomprises a comfort manifold and a third encapsulating member coupled tothe first encapsulating envelope to form a second encapsulatingenvelope, wherein the second encapsulating envelope encapsulates atleast a portion of the comfort manifold, and wherein the thirdencapsulating member has a plurality of apertures.
 7. The system ofclaim 1 wherein the first encapsulating envelope comprises apolyurethane material.
 8. The system of claim 1 further comprising: afirst adhesive on the patient-facing side of the sealing member; and asecond adhesive disposed between the sealing member and the firstencapsulating envelope, wherein the first adhesive is operable to couplethe sealing member to the patient, wherein the second adhesive isoperable to couple the sealing member to the first encapsulatingenvelope.
 9. The system of claim 8 further comprising: a releasablebacking that covers the first adhesive, the releasable backing beingremovable to expose the first adhesive.
 10. The system of claim 8wherein the first adhesive and the second adhesive comprise an acrylicadhesive material.
 11. The system of claim 1 wherein thereduced-pressure bridge has a length (L) that extends from the tissuesite to a remote location, and wherein L>120 mm.
 12. The system of claim1 wherein the reduced-pressure bridge has a length (L) that extends fromthe tissue site to a remote location, and wherein L>200 mm.
 13. Thesystem of claim 1 wherein the reduced-pressure bridge has a length (L)and a width (W) and wherein L>(4*W).
 14. The system of claim 1 whereinthe delivery manifold is a foam material.
 15. A reduced-pressure bridgefor delivering reduced pressure to a tissue site from a remote site, thereduced-pressure bridge comprising: a delivery manifold operable totransfer the reduced pressure, a first encapsulating envelope at leastpartially enclosing the delivery manifold and having a patient-facingside, a reduced-pressure-interface site formed proximate a second end ofthe reduced-pressure bridge, a second aperture formed on thepatient-facing side of the first encapsulating envelope, wherein reducedpressure is transferable to the tissue site via the second aperture, anda moisture-removing device on at least a portion of the firstencapsulating envelope.
 16. The reduced-pressure bridge of claim 15wherein the moisture-removing device comprises a wicking material on thepatient-facing side of the first encapsulating envelope, the wickingmaterial adapted to contact a remote tissue portion and to absorb liquidfrom the remote tissue portion.
 17. The reduced-pressure bridge of claim15 wherein the first encapsulating envelope comprises: a firstencapsulating member having a first perimeter portion; a secondencapsulating member having a second perimeter portion; and wherein thefirst perimeter portion is coupled to the second perimeter portion suchthat the delivery manifold is at least partially enclosed by the firstencapsulating member and the second encapsulating member.
 18. Thereduced-pressure bridge of claim 17 wherein the first encapsulatingmember and second encapsulating member comprise a polyurethane material.19. The reduced-pressure bridge of claim 16 wherein the wicking materialcomprises a cloth-material drape.
 20. The reduced-pressure bridge ofclaim 16 wherein the wicking material comprises a non-woven fabric. 21.The reduced-pressure bridge of claim 16 wherein the wicking materialcovers at least 50 percent of a patient-facing side of the firstencapsulating envelope.
 22. The reduced-pressure bridge of claim 16wherein the wicking material covers at least 70 percent of apatient-facing side of the first encapsulating envelope.
 23. Thereduced-pressure bridge of claim 16 wherein the wicking material coversat least 80 percent of a patient-facing side of the first encapsulatingenvelope.
 24. The reduced-pressure bridge of claim 16 wherein thewicking material extends along a length of the first encapsulatingenvelope.
 25. The reduced-pressure bridge of claim 15 wherein themoisture-removing device comprises a comfort manifold and a thirdencapsulating member for encapsulating at least a portion of the comfortmanifold on the patient-facing side and wherein the third encapsulatingmember has a plurality of apertures.
 26. The reduced-pressure bridge ofclaim 15 wherein the reduced-pressure bridge has a length (L), andwherein L>120 mm.
 27. The reduced-pressure bridge of claim 15 whereinthe reduced-pressure bridge has a length (L), and wherein L>200 mm. 28.The reduced-pressure bridge of claim 15 wherein the reduced-pressurebridge has a length (L) and a width (W) and wherein L>(4*W).
 29. Thereduced-pressure bridge of claim 15 wherein the delivery manifold is afoam material.
 30. A method for delivering reduced pressure to a tissuesite at a limited-access location, the method comprising the steps of:disposing a first manifold proximate the wound; disposing a sealingmember over the first manifold, the sealing member having a firstaperture; providing a reduced-pressure bridge having a first end and asecond end, the reduced-pressure bridge having a second apertureproximate the first end and having a second manifold and amoisture-removing device; coupling a reduced-pressure interface to thesecond end of the reduced-pressure bridge; disposing the first end ofthe reduced-pressure bridge over at least of portion of the sealingmember with the second aperture substantially aligned with the firstaperture; and fluidly coupling a reduced-pressure source to thereduced-pressure interface.
 31. The method of claim 30 wherein themoisture-removing device comprises a wicking layer.
 32. The method ofclaim 30 wherein the moisture-removing device comprises a comfortmanifold and an encapsulating member for encapsulating at least aportion of the comfort manifold on a patient-facing side of thereduced-pressure bridge and wherein the encapsulating member has aplurality of apertures.
 33. A reduced-pressure treatment kit, thereduced-pressure treatment kit comprising: a reduced-pressure interface;a reduced-pressure delivery conduit; a manifold unit, the manifold unithave a plurality of preformed treatment manifolds; and a perforatedsealing sheet, the perforated sealing sheet operable to be torn into aplurality of securing strips and a sealing member; a reduced-pressurebridge, the reduced-pressure bridge comprising: a delivery manifoldoperable to transfer the reduced pressure to the treatment manifold, afirst encapsulating envelope at least partially enclosing the deliverymanifold and having a patient-facing side, a reduced-pressure-interfacesite formed proximate a second end of the reduced-pressure bridge, anaperture formed on the patient-facing side of the first encapsulatingenvelope, wherein reduced pressure is transferred to a tissue site viathe second aperture; and a moisture-removing device on at least aportion of the first encapsulating envelope.
 34. The reduced-pressuretreatment kit of claim 33 further comprising a ruler.
 35. Thereduced-pressure treatment kit of claim 33 further comprising a packageand wherein the package surrounds the reduced-pressure bridge, thereduced-pressure interface, the reduced-pressure conduit, the manifoldunit, and the perforated sealing sheet.
 36. The reduced-pressuretreatment kit of claim 33 wherein the reduced-pressure interface iscoupled to the reduced-pressure-interface site of the reduced-pressurebridge and the reduced-pressure delivery conduit is coupled to thereduced-pressure interface.
 37. The reduced-pressure treatment kit ofclaim 33 wherein the first encapsulating envelope comprises: a firstencapsulating member having a first perimeter portion; a secondencapsulating member having a second perimeter portion; and wherein thefirst perimeter portion is coupled to the second perimeter portion. 38.The reduced-pressure treatment kit of claim 37 wherein themoisture-removing device comprises a wicking material on thepatient-facing side of the first encapsulating envelope, the wickingmaterial adapted to contact a remote tissue portion and to absorb liquidfrom the remote tissue portion.
 39. The reduced-pressure treatment kitof claim 37 wherein the moisture-removing device comprises a comfortmanifold and a third encapsulating member for encapsulating at least aportion of the comfort manifold on the patient-facing side and whereinthe third encapsulating member has a plurality of apertures.